目的 评价急性心肌梗死合并心源性休克老年患者行急诊介入治疗时常规主动脉内球囊反搏术(IABP)的有效性和安全性.方法 52例在IABP支持下行急诊介入治疗的合并心源性休克的急性心肌梗死患者为治疗组,将同期行急诊介入治疗但没有行1ABP支持的合并心源性休克的急性心肌梗死患者45例设为对照组;比较两组术后1个月、3个月以及6个月的左室功能和主要心血管事件(MACE)发生率;并同时统计IABP并发症的发生率.结果 IABP组患者术后1个月、3个月和6个月的左室射血分数较对照组明显改善[(44.5%±8.2%)和(36.3%士4.7%),(46.7%±5.6%)和(39.1%±4.5%),(46.7%±5.6%)和(39.1%±4.5%),P＜0.05];两组患者术后1个月(12/52和25/45)、3个月(15/52和30/45)和6个月(17/52和37/45)的MACE事件发生率间差异均有统计学意义(P＜0.05).IABP并发症发生率为23.1%,严重并发症发生率为7.7%.结论 对合并心源性休克的急性心肌梗死老年患者行急诊PCI同时采用IABP支持治疗能有效改善左室功能和减少主要心血管不良事件的发生率,但IABP并发症发生率明显增多.%Objective To assess the efficacy and safety of intra - aortic balloon pump ( IABP ) support in aged patients with acute myocardial infarction ( AMI ) complicated with cardiogenic shock ( CS ) undergoing percutaneous coronary intervention ( PCI ).Methods Clinical data of 52 patients with AMI complicated with CS who had received emergency PCI with IABP support were retrospectively reviewed, with another 45 patients of the same condition received emergency PCI without IABP support included as the control group.Left ventricular ejective function was evaluated in both groups at the time points of 1, 3, and 6 months after the operation, with the incidence rate for Major adverse cardiovascular events ( MACE ) compared between the two groups.Results Left ventricular function at 1 month, at 3months and at 6months after operation in patients with IABP support improved remarkbaly compared to the control group [( 44.5％ ±8.2％ ) vs ( 36.3％ ±4.7％ ), ( 46.7％ ±5.6 ) vs ( 39.1％ ±4.5％ ), (46.7％ ±5.6％ ) vs ( 39.1％ ±4.5％ ), all P ＜0.05].Significant differences also existed in incidence rate of MACE ( 12/52vs25/45, 15/52vs30/45 , 17/52vs37/45, all P ＜0.05 ).Incidence rate for IABP complications was 23.1％ , and the percentage was 7.7％ for serious complication.Conclusion AMI - CS patients undergoing PCI can benefit from IABP support in terms of left ventricular functions and reduced MACE prevalence.But incidence rate for IABP complications is high in aged patients.
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